Anesthesiology
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Randomized Controlled Trial
Effect of Mechanical Ventilation Mode Type on Intra- and Postoperative Blood Loss in Patients Undergoing Posterior Lumbar Interbody Fusion Surgery: A Randomized Controlled Trial.
Pressure control ventilation is associated with lower surgical bleeding volume when compared to volume controlled ventilation during lumbar spine surgery.
pearl -
Review Meta Analysis
Restrictive versus Liberal Transfusion Strategy in the Perioperative and Acute Care Setting. A Context-specific Systematic Review and Meta-analysis of Randomized Controlled Trials.
Blood transfusions are associated with morbidity and mortality. However, restrictive thresholds could harm patients less able to tolerate anemia. Using a context-specific approach (according to patient characteristics and clinical settings), the authors conducted a systematic review to quantify the effects of transfusion strategies. ⋯ Restrictive transfusion strategies should be applied with caution in high-risk patients undergoing major surgery.
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Randomized Controlled Trial
Continuous Positive Airway Pressure Mitigates Opioid-induced Worsening of Sleep-disordered Breathing Early after Bariatric Surgery.
Bariatric surgery patients are vulnerable to sleep-disordered breathing (SDB) early after recovery from surgery and anesthesia. The authors hypothesized that continuous positive airway pressure (CPAP) improves postoperative oxygenation and SDB and mitigates opioid-induced respiratory depression. ⋯ This pharmacophysiologic interaction trial shows that supervised CPAP treatment early after surgery improves SDB and ameliorates the respiratory-depressant effects of opioids without undue hemodynamic effects.